Quantification of plaque characteristics detected by dual source computed tomography angiography to predict myocardial ischemia as assessed by single photon emission computed tomography myocardial perfusion imaging
Quantification of plaque characteristics detected by dual source computed tomography angiography to predict myocardial ischemia as assessed by single photon emission computed tomography myocardial perfusion imaging
复制标题
通过双源计算机断层扫描血管造影检测到的斑块特征的量化，以预测通过单光子发射计算机断层扫描心肌灌注成像评估的心肌缺血
DOI：
10.21037/qims.2019.04.07
复制
发表时间：
2019-04-01
影响因子：
2.8
通讯作者：
Dai, Xu
中科院分区：
文献类型：
--
作者：
Liu, Ting;Yuan, Xue;Dai, Xu
背景：我们的目的是评估双源计算机断层扫描血管造影（DSCTA）检测到的定量斑块特征与单光子发射计算机断层扫描心肌灌注成像（SPECT-MPI）评估的心肌缺血之间的关系。 方法：在本研究中，连续460例疑似冠状动脉疾病（CAD）患者接受了DSCTA和应激/静息SPECT-MPI，并对179例冠状动脉斑块患者进行了定量分析。定量冠状动脉斑块测量，包括总斑块体积、非钙化斑块体积、钙化斑块体积、低密度非钙化斑块体积、斑块总负荷、钙化斑块负荷、非钙化斑块负荷、低密度非钙化斑块（LDNCP）负荷、重塑指数、斑块长度、最大直径狭窄由自动化软件（5.6.5版，Circle Cardioangio Imaging，加拿大）提供。采用单变量和多变量 Logistic 回归分析来评估定量斑块特征与心肌缺血之间的相关性，以确定斑块特征是否独立于临床危险因素和显着 CAD。 结果：考虑了 179 名疑似 CAD 患者（65% 男性），接受 DSCTA 和应激/静息 SPECT-MPI 以及单血管缺血。斑块特征的定量评估与心肌缺血之间存在显着相关性，具体如下：斑块总体积[25.2（17.8-37.8）与15.6（10.3-24.9）mm（3），P=50%和性别（AUC 0.729；95% CI，0.633-0.825）。结论：DSCTA检测到的斑块定量特征为与可疑 CAD 患者 SPECT-MPI 检测的心肌缺血发生率独立相关。
Background: We aim to evaluate the relationship between quantitative plaque characteristics detected by dual-source computed tomography angiography (DSCTA) and myocardial ischemia as assessed by single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI).Methods: In this study, 460 consecutive patients with suspected coronary artery disease (CAD) underwent DSCTA and stress/rest SPECT-MPI, and 179 patients with coronary artery plaques were quantitatively analyzed. Quantitative coronary artery plaque measurements including total plaque volume, the volume of non-calcified plaque, calcified plaque volume, low-density noncalcified plaque volume, total plaque burden, calcified plaque burden, non-calcified plaque burden, low-density non-calcified plaque (LDNCP) burden, remodeling index, plaque length, maximum diameter stenosis were provided by the automated software (Release 5.6.5, Circle Cardiovascular Imaging, Canada). Univariate and multivariate logistic regression analysis was performed to assess the correlation between quantitative plaque characteristics and myocardial ischemia to determine if plaque characteristics were independent of clinical risk factors and significant CAD.Results: One hundred and seventy-nine patients (65% males) with suspected-CAD, undergoing DSCTA and stress/rest SPECT-MPI and single vessel ischemia were considered. There were significant correlations between quantitative assessment of plaque features and myocardial ischemia with details as follow: total plaque volume [25.2 (17.8-37.8) vs. 15.6 (10.3-24.9) mm(3), P= 50% and gender (AUC 0.729; 95% CI, 0.633-0.825).Conclusions: Quantitative plaque characteristics detected by DSCTA are independently correlated with the incidence of myocardial ischemia by SPECT-MPI in patients with suspected CAD.